Organization Active NPI

Limb Preservation Center of East Tennessee PLLC

  • Family Medicine Physician
  • Lenoir City, TN
National Provider Identifier
1497457964
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LIMB PRESERVATION CENTER OF EAST TENNESSEE PLLC
Practice address
460 Medical Park Dr Ste 108B
Lenoir City, TN 37772-5782
Phone
(865) 562-3232
NPI assigned
Mar 20, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Heather Filer
Title
Credentialing Manager
Phone
(561) 312-1082

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Wound Care Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WW0000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

460 Medical Park Dr Ste 108B
Lenoir City, TN 37772-5782

Mailing address

460 Medical Park Dr Ste 108B
Lenoir City, TN 37772-5782
Phone (865) 562-3232

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230915002486 TN Part B Supplier - Clinic/Group Practice 5890155089 Receives reassigned benefits from 3 practitioners
Practice locations: Lenoir City, TN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D2281432Limb Preservation Center of East Tennessee460 Medical Park Dr #108B, Lenoir City, TN 37772Certificate of waiverMay 7, 2027

National Provider Directory

National Provider Directory

Locations

460 Medical Park Dr
Ste 108B
Lenoir City, TN 37772
Phone (865) 562-3232

460 Medical Park Dr
#108
Lenoir City, TN 37772
Phone (865) 271-9536

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1679270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684195200000",
    "number": "1497457964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 MEDICAL PARK DR STE 108B",
            "city": "LENOIR CITY",
            "state": "TN",
            "postal_code": "377725782",
            "telephone_number": "865-562-3232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 MEDICAL PARK DR STE 108B",
            "city": "LENOIR CITY",
            "state": "TN",
            "postal_code": "377725782",
            "telephone_number": "865-562-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIMB PRESERVATION CENTER OF EAST TENNESSEE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-20",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A",
        "authorized_official_last_name": "FILER",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "561-312-1082"
    },
    "taxonomies": [
        {
            "code": "163WW0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Wound Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lenoir City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.